Transcutaneous Carbon Dioxide Monitoring with Reduced-Temperature Probes in Very Low Birth Weight Infants

Abstract

Background Obtaining blood gases in very low birth weight (VLBW) infants is an invasive procedure. Studies using transcutaneous carbon dioxide (tcPCO₂) have reported variable skin complications with high-temperature probes. No enough data available on tcPCO₂ monitoring using reduced-temperature probes (41°C).

Objective The objective of this study was to assess reliability and safety of tcPCO₂ monitoring at reduced-temperature probe in VLBW infants.

Design and Methods A prospective study was conducted on VLBW infants. tcPCO₂ was monitored for 12 hours. Default skin probe temperature was adjusted at 41°C. Blood gases were done as clinically indicated. Arterial partial pressure of CO₂ (PaCO₂) as well as capillary CO₂ were compared with simultaneous tcPCO₂.

Results A total of 124 data points were identified from 50 patients (gestational age [GA] = 28.1 ± 2.4 weeks and birth weight [BW] = 1,035 ± 291 g). Patients were supported with continuous positive airway pressure (40%), noninvasive positive pressure ventilation (16%), mechanical ventilation (18%), and high-frequency oscillation ventilation (24%). PaCO₂ was measured using either capillary (58%) or arterial (42%) samples. Mean CO₂ did not differ between tcPCO₂ (51.3 ± 16) and PaCO₂ (49.1 ± 13.7) mm Hg. tcPCO₂ showed positive correlation with partial pressure of CO₂ (r = 0.6, p < 0.001). This correlation continued to be significant after controlling for GA, postmenstrual age, type of sample, and pH. No skin complications were reported.

Conclusion tcPCO₂ monitoring using a temperature of 41°C is feasible and reliable in VLBW infants.

Keywords

transcutaneous carbon dioxide - VLBW - premature infants - blood gas

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